Individual
SHANNON MARIE MILLIGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CN
Contact information
Practice address
916 SW KING AVE STE 101, PORTLAND, OR 97205-1331
(503) 954-6677
Mailing address
916 SW KING AVE STE 101, PORTLAND, OR 97205-1331
(503) 954-6677
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
61480409
WA
246Z00000X
Other Specialist/Technologist
Primary
BAP-E-10256316
OR
Other
Enumeration date
02/21/2024
Last updated
05/24/2025
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